The Trim Healthy Mamas are back with this simple, family-friendly, (and secretly healthy!) casserole recipe. 

Each product we feature has been independently selected and reviewed by our editorial team. If you make a purchase using the links included, we may earn commission.
Pizza Casserole Trim Healthy Mamas
Credit: Rohnda Monroy

Just a few years ago, we wrote a self-pulished book and titled it Trim Healthy Mama, never guessing in our wildest dreams what would happen with it. Women began to discover the book and it resonated with a longing they had deep down in their sould. Like us, they felt "done" with diets and yearned for a doable way of eating that would enable long-term success rather than short-term extreme results.

Our new book, Trim Healthy Table, features more family-style "get 'er done" recipes including this yummy casserole. Oven-baked casseroles and bakes are the meals that draw your family around the table and create lasting memories of the taste of home. Now they can be trimming and healthy too! (RELATED: Trim Healthy Mamas' Lazy Lasagna Recipe)

Easy Pizza Casserole

  • Coconut oil cooking spray
  • 2 (10- to 12-ounce) bags frozen riced cauliflower
  • 3 large eggs
  • 1 cup egg whites (carton or fresh)
  • ¾ teaspoon salt
  • ½ teaspoon garlic powder
  • 2 cups grated part-skim mozzarella cheese
  • 1 pound mild, medium, or hot Italian-style sausage meat (we use turkey, but you can use any kind), thawed if frozen
  • 1 (10-ounce) bag frozen small-cut seasoning blend (diced onion, celery, and bell pepper)
  • 5 ounces pepperoni, diced (we use turkey, but you can use any kind)
  • ½ teaspoon dried oregano
  • Red pepper flakes to taste
  • 1 (14-ounce) jar sugar-free pizza sauce
  1. Preheat the oven to 400⁰F. Spray a 9 x 13-inch baking dish with coconut oil.
  2. Mix together the cauliflower rice, whole eggs, egg whites, salt, garlic powder, and 1 cup of the mozzarella in a large bowl. Scrape the mixture into the baking dish, then spread it evenly and smooth the top with a spatula. Cover and bake for 20 minutes. Uncover and bake for another 20 minutes (a total of 40 minutes).
  3. While the base of the casserole is baking, make the topping. Set a skillet over medium-high heat and add the sausage, seasoning blend, and half of the diced pepperoni and brown the meat. Add the oregano and red pepper flakes. Cook the meat and seasoning blend until all the liquid has evaporated. Stir in the pizza sauce and remove from the heat.
  4. Remove the casserole base and set the oven to high broil. Pour the meat sauce mixture over the casserole base, top with the remaining 1 cup mozzarella, then the remaining pepperoni. Return to the broiler and broil until the cheese is bubbling and the pepperoni gets slightly browned.
Trim Healthy Table cookbook cover

Adapted from Trim Healthy Table. Copyright © 2017 by Pearl Barrett & Serene Allison. Published by Harmony Books, an imprint of the Crown Publishing Group, a division of Penguin Random House LLC.